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Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Now that they’ve gotten an EMR in shape to collect Meaningful Use payouts, hospitals are examining what those incentive bucks have gotten them. And apparently, many aren’t happy with what they see. In fact, it looks like a substantial number of hospitals are ripping and replacing existing EMRs with yet another massive system.

But if they thought that the latest forklift upgrade would be the charm, many were wrong. A new study by Black Book Research suggests that in the frenzy to replace their current EMR, many hospitals aren’t getting what they thought they were getting. In fact, things seem to be going horribly wrong.

Black Book recently surveyed 1,204 hospital executives and 2,133 user-level IT staffers that had been through at least one large EMR system switch to see if they were happy with the outcome. The results suggest that many of these system switches have been quite a disappointment.

According to researchers, hospitals doing new EMR implementations have encountered a host of troubles, including higher-than-expected costs, layoffs, declining inpatient revenues and frustrated clinicians. In fact, hospitals went in to these upgrades knowing that they would not be back to their pre-EMR implementation patient volumes for at least another five years, but in some cases it seems that they haven’t even been keeping up with that pace.

Fourteen percent of all hospitals that replaced their original EMR since 2011 were losing inpatient revenue at a pace that would not support the total cost of the replacement EMR, Black Book found. And 87% of financially threatened hospitals now regret the executive decision to change systems.

Some metrics differed significantly depending on whether the respondent was an executive or a staff member.

For example, 62% of non-managerial IT staffers reported that there was a significantly negative impact on healthcare delivery directly attributable to an EMR replacement initiative. And 90% of nurses said that the EMR process changes diminished their ability to deliver hands-on care at the same effectiveness level. In a striking contrast, only 5% of hospital leaders felt the impacted care negatively.

Other concerns resonated more with executives and staff-level respondents. Take job security. While 63% of executive-level respondents noted that they, or their peers, felt that their employment was in jeopardy to the EMR replacement process, only 19% of respondents said EMR switches resulted in intermittent or permanent staff layoffs.

Meanwhile, there seemed to be broad agreement regarding interoperability problems. Sixty-six percent of system users told Black Book that interoperability and patient data exchange functions got worse after EMR replacements.

What’s more, hospital leaders often haven’t succeeded in buying the loyalty of clinicians by going with a fashionable vendor. According to Black Book, 78% of nonphysician executives surveyed admitted that they were disappointed by the level of clinician buy-in after the replacement EMR was launched. In fact, 88% of hospitals with replacement EMRs weren’t aware of gaining any competitive advantage in attracting doctors with their new system.

Now, we all know that once a tactic such as EMR replacement reaches a tipping point, it gains momentum of its own. So even if they read this story, my guess is that hospital executives planning an EMR switch will assume their rollout will beat the odds. But if it doesn’t, they can’t say they weren’t warned!

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I think that most of you know how I feel about the various EHR ranking systems. They all have their issues, but they are another interesting data point in the search for the right EHR. Plus, the EHR ranking trends over time can be interesting. Not to mention, it’s hard not to look at a post that has rankings. It’s almost un-American not to look.

So, I figured I’d post some of the Black Book Rankings over the next week. The following are the Top Ranked EHR Vendors for Inpatient Hospital Systems, Chains and IDN (in alphabetical order).

Not too many surprises on the list. Was their any Hospital EHR vendor that you think should have made it on this list? I think this list would be more interesting if it just ranked the top 5 Hospital EHR vendors.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve long had an interest in EHR certification. While the idea of certifying software sounds good on face, once you start digging in it starts to stink. At least I make my bias known up front. My least favorite phrase when it comes to EHR certification is that it provides an “assurance” to the EHR buyer. EHR certification doesn’t assure the EHR buyer of anything useful.

Considering my long interest in EHR certification, I decided I’d take a quick look at the various CCHIT EHR certifications that have been done in this new post-HITECH Act era of EHR certification. The number of EHR vendors is quite interesting as reported on the CCHIT website (I’ll look into the other ONC-ATCB in future posts).

In my quick count of ONC ATCB certified EHR products I counted 31 Hospital EHR (trying to take out the duplicates from the same EMR company). A number of those are ED EHR, but it’s interesting to see the scale of inpatient hospital EHR software that are certified by CCHIT.

Just for fun, I took at look at the full CCHIT certification for inpatient EHR. Only 4 inpatient EHR were listed.

The message here is that hospitals don’t use CCHIT’s full certification as a differentiator when they’re selecting an EHR. All they seem to care about is ONC-ATCB EHR Certification. While I still think it’s mostly redundant to meaningful use, I appreciate that it’s a step in the right direction.

When I first started Hospital EMR and EHR, I started this list of Hospital EHR vendors. It still needs some work, but I’d love to hear of other Hospital EHR companies that I should add to the list.